UNDERSTANDING NASAL BREATHING IN AESTHETIC;
The nose is a very complex and multifunctional organ. It is important to understand the anatomy and physiology of the nose airway, the causes of obstruction, proper assessment and appropriate treatment for rhinoplasti. Today’s classical treatment method usually involves routine subcucosal excision of the septum and inferior Concha surgeries. However, most airway obstruction is not structural but rather physiologic, and therefore, most patients without surgical treatment medical treatment is sufficient. The latest developments have shown that nasal valves can play a more important role than septum. The ideal rhinoplasty involves maintaining or correcting the nasal airway.
NOSE ANATOMY IN TERMS OF AIRWAY
Nasal muscles; the most important muscle ‘levator labii superioris aleque nasi’dir. This allows the external valve to be wider by opening the nasal wings. The other muscles maintain the structural stability of the nose when negative pressure occurs.
NOSE VALVES IN TERMS OF AIRWAY;
When the air enters the nose, it travels through certain narrow roads. There are two important valves in the nose.
Internal nasal valve is a passage between the upper lateral cartilages in the inferiors of the nasal bone and the septum at an average distance of 15 degrees. The outer part of this passage is the nose flesh called inferior Concha. A small shortage of this passage leads to significant problems in breathing.
External nasal valve; located in the lower region. The inferior lateral cartilage forms the lateral and middle or even membranous septum and nasal base of the nose. Deep breathing closes the nose wings. This reduces the amount of air entering during breathing.
NASAL PHYSIOLOGY IN TERMS OF AIRWAY;
There are seven basic functions of the nose; breathing, air humidification, heating the air, cleaning the air particles, sound production and secondary sexual organ functions such as. Over time, the smell has decreased and the nose has become the main respiratory organ.
Ohms Law is the most important physics law that describes the air dynamics of the nose. The air flow is proportional to the difference in pressure; resistance is proportional to the opposite. In other words, when the pressure between the nasopharynx is formed, the air flow occurs through the nose. Thus, structural constraints caused by hypertrophic Concha, septal deviations, valv insufficiencies decrease in air flow.
Humidification occurs 90% of the humidification of air before the air reaches the lungs during breathing. Approximately 1 lt of water per day is needed.
Heat regulation; air before reaching the throat is heated almost to body temperature. Even the air at 5 degrees Celsius is heated between 31-37 degrees during respiration. This can cause chronic pharyngitis, lung disturbances, and exacerbation of existing allergies.
Filtration removes air through tightening, electrostatic change, mucosilier pillows. Many lung diseases are very important to meet with fresh air.
Our taste increases with the smell directly. On the contrary, unpleasant odors act as a warning for potential environmental hazards. There is a strong connection between smells and memory. Smell disorders can also be part of systemic diseases.
PATIENT HISTORY IN TERMS OF AIRWAY
The frequency of symptoms should be questioned in terms of single terafli and bilateral, periodical, trauma history, surgical history, allergic body presence.
A change in the color of the lower eyelid, redness in the eyes, indicates an allergic condition. External and internal valv angles should be evaluated. The test is performed to increase the angle of the internal Val and nasal breathing increases and even this test alone diagnoses. The light source may be sufficient for the preliminary examination. Endoscopic examination or paranasal tomography is required to evaluate the posterior part of the nose.
For evaluation of Concha, Concha can be evaluated again after application of 0.25% phenylephrine which reduces blood flow to the nose. If there is no significant decrease in the size of the concha there are two possibilities. First, the patient is using an uncontrolled nose sprays or cocaine. The secondary and more common cause is hypertrophic (enlarged) of the bones in the nasal cones.
WHAT ARE THE SYMPTOMS OF NASAL OBSTRUCTION?
Rhinitis; flu, such as illnesses. Nasal congestion is the most common cause of airway obstruction. Usually occurs due to a virutic cause. Most of the time, self-limiting and healing happens. Treatment is directed towards symptoms
Allergic rhinitis; prevalence in the United States is between 14-31%. True allergic rhinitis is skidged from pollen or fungal sports in the air and is mostly seasonal. Patients should be given treatment according to their condition. It is treated with steroid and antihistamine sprays, but should not be used for long periods of time.
Vasomotor rhinitis; an imbalance in sympathetic /parasympathetic autonomic system leads to a constant watery reaction. This is often the case with idiopathic pregnancy.
Atrophic rhinitis is associated with excessive excision of Concha in the operation, but this issue is controversial. This is rare. It is usually characterized by progressive, slow atrophy of the nose mucosa, with poor dreanage, and a post-adolescence shell.
Rhinitis mediacza; often in patients with nasal congestion after long-term use of nasal drops or sprays (Africa, such as Dristan) occurs.
Post-rhinoplasty rhinitis occurs after the nose surgery. After the operation, temporary mucosal edema and crustaceans are common. The patient is not required to treat other than suggestions. If necessary, medical treatment may be given.
The treatment of nasal airway varies depending on the etiologic and pathological characteristics of the problem. Nasal airway treatments can often be performed using non-surgical treatments. The air passages have shown that the valves of the nose play a more important role for the problems that require surgical intervention. A thorough understanding of the nose airway will allow the more appropriate evaluation of the nose airway problem to be diagnosed and treated.
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